Contemporary Pediatrics: Don’t rule out sports for children with bleeding disorders

Contact Sports

By Rachael Zimlich

Finding a way to incorporate normal, healthy sports and exercise with safety in children with bleeding disorders can be tricky, but it can be done.

Shannon Carpenter, MD, MS, FAAP, professor of Pediatric Hematology/Oncology at the University of Missouri-Kansas City School of Medicine, director of the Kansas City Regional Hemophilia Treatment Center, and director of the anticoagulation management program at Children's Mercy Hospital, Kansas City, Missouri, delivered a presentation titled “Bleeding disorders and physical activity: Current recommendations” at the American Academy of Pediatrics (AAP) 2018 National Conference and Exhibition that highlighted some new recommendations for children and teenagers with bleeding disorders and how pediatricians can help guide their activities.

First of all, Carpenter says some physical activity is beneficial for children with hemophilia and other bleeding disorders, but those activities should be chosen carefully to avoid doing more harm than good.

"In general, avoid contact sports—sports where you are supposed to hit someone—and those with high risk of head injury, like diving," Carpenter says. "Activity guidelines for other bleeding disorders are extrapolated from knowledge about hemophilia. Some people with milder bleeding disorders may be able to do more vigorous activity. Often, the recommendations are tailored to the individual."

Carpenter points out that children who are regularly active have been found to have fewer bleeding episodes, decreased joint damage, and improved bone density. Vigorous exercise has even been shown to help increase factor VIII levels transiently in mild and moderate hemophilia A, she says.

"The approach to the patient must be holistic. While we don’t want to forget their bleeding disorder, we also want them to be healthy individuals with good quality of life," Carpenter says. "We want to enable patients with bleeding disorders to participate in physical activity as much as is reasonable to optimize their health and quality of life."